Provider Demographics
NPI:1689405755
Name:HIGGIN, DIAMOND SASHA
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:SASHA
Last Name:HIGGIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 SEYMOUR RD
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1164
Mailing Address - Country:US
Mailing Address - Phone:302-685-7971
Mailing Address - Fax:
Practice Address - Street 1:722 E PULASKI HWY STE 102
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6061
Practice Address - Country:US
Practice Address - Phone:302-685-7971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD183261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice